D.C. Takes the National HIV/AIDS Strategy to Task on Inclusion

The second in a series of articles about the Road to AIDS 2012, a 15-city tour that seeks to define the state of the U.S. epidemic and that leads up to the International AIDS Conference in Washington, D.C., in July 2012. The first installment reported on the Bay Area meeting.

The meeting, held Nov. 3 in Washington, D.C., drew a crowd of 110 to hear panelists talk about the local successes and challenges in HIV/AIDS prevention and treatment. Members of the audience and participants on the six-person panel spoke time after time about how the NHAS fails to communicate directly to various segments of the community.

Panelist Ebony Johnson, a coordinator for the Women's Networking Zone, which spotlights women's issues in relation to the HIV/AIDS crisis, pointed out how women's needs have been largely ignored. "We need to make sure that women's issues are funded, because women don't live in isolation," she said. Not only that, but the NHAS must take into consideration the fact that women come from all backgrounds and can't be compartmentalized, she said. The needs of mothers should be recognized, but so, too, should the needs of female sex workers, drug users and caretakers.

Another group that has felt ignored is local youths, said Brandon Holden, an audience member who introduced himself as a teenager working in HIV prevention in Washington, D.C. "I'm concerned about a lack of youth-specific language in the National HIV/AIDS Strategy," Holden said.

Megan McLemore, a senior researcher in the Health and Human Rights Division of Human Rights Watch, pointed out from the audience that sex workers and drug users are often left out of the conversation about fighting the HIV/AIDS epidemic. She then said that during large conferences, "sex workers, drug workers and homeless people are often moved away and made invisible." Such an action would be particularly counterproductive when AIDS 2012 takes place in Washington, D.C., in July, she added.

One audience member commented that there is no language in the NHAS that speaks directly to seniors, while another spoke of how Africans that live in America are often overlooked, even while many are dealing with the HIV/AIDS crisis not only in the United States but also in their home countries in Africa.

While there are no easy answers when it comes to ensuring that all groups have their voices heard, panelist Phill Wilson, founder and CEO of the Black AIDS Institute, suggested that all groups that feel marginalized take it upon themselves to create their own strategy for dealing with the epidemic. After citing the work that the Institute has done to create a national strategy for Black America, Wilson, who is also a member of the Presidential Advisory Council on HIV/AIDS and the AIDS 2012 Conference Coordinating Committee, suggested that individuals get together and do the same, forming, for example, a national strategy for youths and a national strategy for women. "At the end of the day, that's how these things are going to change," he said.

Panelists and audience members also lauded some of Washington, D.C.'s successes in dealing with the epidemic. Panelist Greg Pappas, M.D., Ph.D., senior director of the HIV/AIDS, Hepatitis, STD and TB Administration for the Department of Health in the District of Columbia, pointed out that the District of Columbia has the second-highest rate of health insurance coverage in the nation after Massachusetts, with 96 percent of children and 93 percent of adults covered. Dr. Pappas also described the District's success in moving people off the AIDS Drug Assistance Program (ADAP) and onto expanded Medicaid. Finally, he said that the District has expanded testing efforts, going from administering 20,000 tests to 130,000 in the last couple of years. "And this year we'll exceed last year," he added.

Panelist Alan Greenberg, M.D., M.P.H., professor and chair of the department of epidemiology and biostatistics at George Washington University, described the District of Columbia's Developmental Center for AIDS Research (D-CFAR), which aims to increase HIV/AIDS research in Washington, D.C., and reduce HIV infections and morbidity in the area. The effort is a collaboration between local academic institutions and hospitals, including George Washington University, Children's National Medical Center, Georgetown University, Howard University and the Washington, D.C., Veterans Affairs Medical Center. "We're trying to make D.C. a center for research," he said.

The other panelists who took part in the conversation were Jeffrey Crowley, director of the Office of National AIDS Policy and senior adviser on disability policy at the White House, and Fred Sawe, M.B.Ch.B, M.Med., deputy director of the Kenya Medical Research Institute/Walter Reed Project.

The Road to AIDS 2012 is a collaboration between the Washington, D.C.-based Community Education Group, the Urban Coalition for HIV/AIDS Prevention Services, pharmaceutical company Merck and AIDS 2012. The Road to AIDS 2012 will seek community input in cities across the country. That input will be shared at AIDS 2012 in Washington, D.C., when the International AIDS Conference is on American soil for the first time in more than 20 years.

One of the biggest takeaways from the Washington, D.C., town hall meeting was that change starts not with government but with the people. "Anything effective always starts with the community," Wilson said.

Tamara E. Holmes is a Washington, D.C.-based journalist who writes frequently about emotional health and wellness.

This article was provided by Black AIDS Institute.
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